Thank you for your interest in volunteering at MetroHealth.

Thank you for your interest in volunteering at Akron Children’s Hospital. Adult volunteers contribute in many ways to our facility by providing comfort, care, and joy to children and their families. We enthusiastically welcome individuals of all backgrounds and abilities who are able to perform tasks independently with minimal supervision. We require our applicants to be at least 18 years of age, in good general health, a non-smoker, able to communicate well in English, and willing to purchase a volunteer uniform ($15).

Commitment and Requirements: Adult volunteers consent to a minimum one year commitment and 50 hours during that year by volunteering weekly as well as one three-hour shift at our Holiday Tree Festival, a major fundraiser presented by the Volunteers of Akron Children’s Hospital.

Interview: A volunteer recruiter will call and schedule an interview with you when an area in which you have expressed interest becomes available. The purpose of the interview is to help us become acquainted and, if accepted, determine your volunteer placement/schedule.

Volunteer Orientation: Orientation attendance is required and provided by Volunteer Services. Following completion of your interview process, you will be contacted to schedule an orientation. The orientation lasts approximately three hours and is offered twice a month. For students, an online orientation is available.

Immunization Requirements

Measles, Mumps & Rubella (MMR) Vaccine*
If an individual was born ON or BEFORE December 31, 1956, no immunization(s) or immune status for measles, mumps or rubella is necessary. All individuals born AFTER December 31, 1956 and BEFORE January 1, 1980 must provide proof of measles, mumps and rubella vaccinations. If an individual was born AFTER December 31, 1979, proof of two MMR vaccines must be provided.

PPD Mantoux Test
PPD Mantoux tests are given to volunteers through Employee Health Office free of charge. All individuals must present proof of a PPD Mantoux test for tuberculosis done within the last twelve months. Individuals with a past positive PPD test must have documentation of a normal chest x-ray done within the past two years and documentation of treatment received.

Varicella (Chickenpox)
All individuals must make known their varicella (chickenpox) immune status. A history of having the disease is acceptable or proof of two doses of the varicella vaccine must be provided.

Flu Vaccine
All individuals are required to receive or have proof of an annual flu vaccine. The FluMist is not acceptable.

Application Process

Complete the application below and submit to Volunteer Services using the red submit button on the bottom right of this form.

New User Details

User ID

User ID (verify)

Password

Password (verify)

Personal Information

Application Entry Date

* First Name

* Last Name

Suffix

Gender

* DOB

* Home Address

* City

* State

* Zip Code

* Cell Phone

Home Phone

Work phone

* E-mail Address

Emergency Contact

* Contact name

* Relationship (Parent, Child, Sibling, etc)

* Cell Phone

Home Phone

Work Phone

_______________________________________________________________________________________________________________________

Employment History

Currently employed

Employment Status

Current Employer

Current Position/Title

Length at current company

Previous employer

Previous position/title

Educational Information

Highest level of education completed

Current student

Current major/course of study

Institution

Expected graduation date

________________________________________________________________________________________________________________________

Volunteer Experiences

Name of previous volunteer organization 1

Volunteer position held with previous organization 1

Start date of previous organization 1

End date of previous organization 1

Name of previous volunteer organization 2

Volunteer position held with previous organization 2

Start date of previous organization 2

End date of previous organization 2

________________________________________________________________________________________________________________________

Volunteer Reason

Why do you want to volunteer with your dog at Akron Children's Hospital?

Adult Availability

Adult Available Hours

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Dog Information

* Dog's Name

* Dog's Date of Birth

Dog's Sex

* Dog's Breed

* Dog's City of Residence

* Dog's Favorite Treat

What Therapy Dog Organization are you registered with?

* 1 Dog's Therapy Dog Org Registration Expiration Date

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Professional References

* Name

Relationship

* Phone

* E-mail

* Name

Relationship

* Phone

* E-mail

_______________________________________________________________________________________________________________________

Background Checks

A record of criminal conviction will not necessarily be a bar to volunteering, since the Hospital will consider factors such as age at time of offense, how long ago the conviction occurred, the nature and seriousness of the violation and evidence of rehabilitation in making a volunteer decision. Since Children's is a pediatric hospital, certain criminal offenses are by Ohio law automatic disqualifiers for volunteer assignments no matter when they occurred.

In the past seven years, have you been convicted of (plead guilty, no contest, or been found guilty) an offense other than minor traffic violations?

Are you charged with a crime that has not yet resulted in a plea of guilty, court trial, deferred adjudication, or dropping of the charge?

If yes to any of the questions above, please explain fully by listing the conviction, the date, and county/state where convicted (failure to disclose a conviction may be considered falsification of your application and disqualify you from consideration for volunteering or result in termination even if discovered at a later date):

If yes to any background check question, please explain:

Since Akron Children's Hospital and its affiliated companies are responsible for children in out-of-home care as defined by S2151.86 (A) (1) of the Ohio Revised Code, the organization must first submit to the Bureau of Criminal Identification and/ora the Federal Bureau of Investigation your fingerprints and general information in order that a background check be conducted to ascertain whether you have been convicted of certain crimes which might disqualify you from eligibility to volunteer. Any applicant who fails to provide the information necessary to complete the required forms or fails to provide impressions of their fingerprints will not be accepted to volunteer for any position.

Your acceptance to volunteer is contingent upon the aforementioned records check not revealing any disqualifying criminal offenses. If you begin volunteering prior to the receipt of this information, volunteering will be conditional. If the records check reveals your conviction of any disqualifying offenses, you will be released from volunteering.

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Statement of Commitment

I hereby affirm that the information provided on this application is true and complete. I understand that any false or misleading representations or omissions may disqualify me from further consideration for volunteer service and may result in discharge even if discovered at a later date. I understand the terms and conditions of my submission to the background check.

I authorize Akron Children's Hospital to verify any information I have provided. I hereby authorize persons from any schools, companies, or organizations, to include my references, named in this application to provide information about me contained in their records, and I release all such persons from liability regarding the provision of or use of such information.

I understand there are certain training requirements that must be fulfilled, and performance standards that must be maintained in order to volunteer at Akron Children's Hospital.

Finally, as an Akron Children's Hospital volunteer, I will:

Agree to volunteer for a minimum of one year and 26 hospital visits and 2 special events within that year
Notify Volunteer Services any time I am unavailable to volunteer for my assignment
Respect patient, family, and staff confidentiality
Abide by the rules and regulations of Akron Children s Hospital and Volunteer Services
Maintain the customer service standards in my interactions with patients, families, and staff
Permit images of photos of me in my role as a volunteer to be used in public relations brochures or videos
Give permission for a background check to be performed by Akron Children's Hospital Security Department

* Volunteer Signature

Typed Name Constitutes Signature